Gas pipeline failures have been reported several times in the anesthesia literature. Petty reviewed pipeline-related deaths from 1972 to 1993 in the US and reported 26 deaths which were due to crossed pipelines, defective connectors, and error in the supply.[1] A survey by the Anesthesia Patient Safety Foundation showed a significant knowledge deficit among anesthesiologists regarding the medical gas pipeline systems (MGPS),[2] and adequacy of knowledge is a must to make the system safe.[3] The past decade witnessed many medico-legal cases compelling the clinicians to shift focus toward practical orientation of the system. Hence, maintaining safety standards is of prime importance starting from the main source at the manifold room to the final delivery point. The two main standards pertaining to MGPS are National Fire Protection Association 99 (US) and HTM 02-01 (UK). Others are British Standards EN 737 (BS EN 737), Compressed Gas Association, Canadian Standards Association, and the International Standards Organization. Cylinders should follow American Society for Testing and Materials standards, and pipes should have Lloyd's certification as per BS 2871..
